| NPI | 1134542517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY SUE BOUCHARD Owner/Manager 248-767-2183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2324558) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |